Online Payment Portal

Online Payment Portal

Welcome to our Online Payment Portal. Quick Pay allows you to make a payment without creating an account or signing in. Create Account and registering your information allows you to make a payment either one-time or recurring, view payment history or manage payment accounts.

To protect your account from unauthorized access, your session will be closed after a period of inactivity. If you have any questions please contact us at 701-662-8832.

User Registration

Is Business Account:

Customer Number:

Username:

First Name:

Last Name:

Company Name:

Secret Question:

Secret Answer:

Confirm Secret Answer:

Address:

Suite/APT#:

City:

State/Region:

Postal Code:

Country:

Phone:

Drivers License:

DL State:

Social Security:

Federal TaxID:

Email Address:

Confirm Email Address:

Patient Name:

Patient Number: